New technology in hospitals Expensive fun or life critical help?

1. New technology in hospitalsExpensive fun or life critical help? Interne tjenester, Medisinsk-teknisk avdeling

2. Challenge Source: http://seniorjournal.com/images/Reference/HealthCare-GDP.jpg Interne tjenester, Medisinsk-teknisk avdeling

3. Industrialization of the health care system Industry: New technology -> More efficient methods -> Personell reductions -> Reduced cost Health care: New technology ->More complex methods -> Increased competence and more personell -> Increased cost Interne tjenester, Medisinsk-teknisk avdeling

4. Trends ”The industry is in superb health and showing no symptoms of slowing down…. In fact, the industry is growing at an estimated compound annual rate of about 8%” ”As one of the fastest growing industries, the market figure for medical devices is expected to exceed the $260 billion mark by the year 2007 ” ”Increased customer cost consciousness is driving efficiency efforts in the industry” ”The need to increase the number and rate at which new products are added to the product portfolio, necessitating significant increases in R&D spending ” Interne tjenester, Medisinsk-teknisk avdeling

5. Trends Health services are low on Maslow’s hierarchy of needs -> Willingness to pay is HIGH Producers of medical technology can be sure that a new product will be profitable, even with only minor changes from excisting methods. Interne tjenester, Medisinsk-teknisk avdeling

6. Local challenge ”Rikshospitalets pasienter skal alltid tilbys de mest avanserte og aller beste metoder innen diagnostikk, behandling og forebygging av sykdommer. Høyspesialisert medisin er et annet stikkord for mye av Rikshospitalets virksomhet” Fra festskrift til Rikshospitalets 175-års jubileum i 2001 Interne tjenester, Medisinsk-teknisk avdeling

7. Local challenge A hospital that wants to be leading, needs the newest and best medical equipment available on the market. The medical equipment is the motor of modern specialized health care. Interne tjenester, Medisinsk-teknisk avdeling

8. Lokal utfordring Årlig reinvesteringsbehov (basert på SHD-levetid og bedriftsøkonomiske prinsipper for avskrivninger) på 130 MNOK for å opprettholde utstyrsparken på 2001-nivå Interne tjenester, Medisinsk-teknisk avdeling

9. Cost saving technology Interne tjenester, Medisinsk-teknisk avdeling

10. FoU-prosjekt kapnografi • Method: CO2-measurements from the exhaustgas port on an oxygenator in order to estimate the arterial CO2 Interne tjenester, Medisinsk-teknisk avdeling

11. Needle positioning Electrical impedance: Z=R+iX or Z=|Z|·exp(jφ) Different types of tissue can be discriminated by looking at the electrical properties Interne tjenester, Medisinsk-teknisk avdeling

12. Expensive technology Interne tjenester, Medisinsk-teknisk avdeling

13. Protontherapy http://www.nature.com/nature/journal/v449/n7159/box/449133a_BX1.html Kilde: NIRS, Chiba, Japan http://www.triumf.info/public/about/virtual_tour.php?section=3&single=18 Interne tjenester, Medisinsk-teknisk avdeling

14. Protontherapy Kilde: NIRS, Chiba, Japan Interne tjenester, Medisinsk-teknisk avdeling

15. Protontherapy An offer to inoparable paitents Kilde: Magne Guttormsen, Fysisk Institutt, UIO Interne tjenester, Medisinsk-teknisk avdeling

16. Protontherapy Better dose distribution in the tumor Kilde: Magne Guttormsen, Fysisk Institutt, UIO Interne tjenester, Medisinsk-teknisk avdeling

17. Protontherapy Kilde: NIRS, Chiba, Japan Interne tjenester, Medisinsk-teknisk avdeling

18. Protontherapy • Minimalized heavy ion therapy centers • Decreased size and complexity • Decreased investment, about 800 mill NOK Kilde: NIRS, Chiba, Japan Interne tjenester, Medisinsk-teknisk avdeling

19. Scintiprobe MR-100 Monitoring computer Isolated limb perfusion • ILP (Isolated Limb Perfusion). Medications Pump Oxygenator Heater cooler Interne tjenester, Medisinsk-teknisk avdeling

20. Isolated limb perfusion 22. Mai 21. Juni 8. Mai Patient with malignant melanoma metastasis in right leg. This image shows extensive necrosis in tumor tissue untill complete respons in day 44 shown to the right. Interne tjenester, Medisinsk-teknisk avdeling

21. Isolated Limb perfusion Interne tjenester, Medisinsk-teknisk avdeling

22. PRISMA PRISMA CRRT: C ontinuous R enal R eplacement T herapies Bildene er lånt ut av overlege Fridtjov Riddervold Interne tjenester, Medisinsk-teknisk avdeling

23. PRISMA PRISMA coupled to an ECMO-circuit. A two months old child with pertussis (whopping cough) with heart failure. Interne tjenester, Medisinsk-teknisk avdeling

24. Right hand, 08/05 PRISMA Interne tjenester, Medisinsk-teknisk avdeling

25. Right hand 15/05 PRISMA Interne tjenester, Medisinsk-teknisk avdeling

26. Right hand 13/06 PRISMA Interne tjenester, Medisinsk-teknisk avdeling

27. PRISMA Starting point: - New procedure, new advanced medical equipment Resultat: - The child was totally rehabilitatet, no signs of late side effects Cost: - ECMO + PRISMA treatment, costa about 130 000,- kr. Each day Interne tjenester, Medisinsk-teknisk avdeling

28. MARS Interne tjenester, Medisinsk-teknisk avdeling

29. MARS Interne tjenester, Medisinsk-teknisk avdeling

30. Artificial heart • Titanmotor able to replace heart function for patients suffering from heart failure • New design, impeller is floating freely in the blood flow • Cost: 800 000,- kr for the device, with personell and other costs it will be around 10 000 000,- kr. Interne tjenester, Medisinsk-teknisk avdeling

31. Artificial heart Interne tjenester, Medisinsk-teknisk avdeling

32. Future • Nanotechnology and molecular engineering • - Nanotechnologic robots may rehabilitate lesions on molecular and cell levels. • - Small sizes (10 -9) m, • - Can be programmed to perform surgical interventions http://www.nanotech-now.com/Art_Gallery/svidinenko-yuriy.htm Interne tjenester, Medisinsk-teknisk avdeling

33. Thank you for your attention More information can be found on our home page: www.med-tek.no Interne tjenester, Medisinsk-teknisk avdeling